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General NPI Number Information
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NPI Number | 1407074669
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Entity Type | Organization
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Legal Business Name | HENDRIKA MATHER M.S., INC., P.S.
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 421 N PEARL ST SUITE 209
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City | ELLENSBURG
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State | WA
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Zip | 98926-3193
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Country | US
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Telephone | 509-925-7522
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Fax |
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Provider Business Mailing Address
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Address Line | 421 N PEARL ST SUITE 209
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City | ELLENSBURG
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State | WA
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Zip | 98926-3193
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Country | US
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Telephone | 509-925-7522
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | HENDRIKA MATHER
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Credential | M.S.
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Telephone | 509-925-7522
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 30002968
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License Number State | WA
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